Original Article Clinical Investigation
Urinary continence after radical prostatectomy: Predictive factors of recovery after 1 year of surgery
Article first published online: 29 JUL 2012
© 2012 The Japanese Urological Association
International Journal of Urology
Volume 19, Issue 12, pages 1091–1098, December 2012
How to Cite
Jeong, S. J., Kim, H. J., Kim, J. H., Oh, J. J., Lee, S. C., Jeong, C. W., Yoon, C. Y., Hong, S. K., Byun, S.-S. and Lee, S. E. (2012), Urinary continence after radical prostatectomy: Predictive factors of recovery after 1 year of surgery. International Journal of Urology, 19: 1091–1098. doi: 10.1111/j.1442-2042.2012.03106.x
- Issue published online: 26 NOV 2012
- Article first published online: 29 JUL 2012
- Received 20 February 2012; accepted 4 July 2012. Online publication 29 July 2012
- natural history;
- predictive factor;
- prostate cancer;
- urinary incontinence
Objectives: To evaluate the clinical prognosis of incontinence and to determine the predictors for further recovery of urinary continence in patients not achieving urinary continence within 1 year after radical prostatectomy.
Methods: A total of 708 patients were evaluated regarding urinary continence status at 1 year after surgery from a prospectively maintained radical prostatectomy database. Of these, 73 (10.3%) did not recover urinary continence within 1 year after surgery. For these patients, incontinence status and the number of pads for urinary control were assessed serially.
Results: In 708 patients, factors associated with the recovery of urinary continence within 1 year after radical prostatectomy were membranous urethral length, prostatic apex shape and patient age. Among 73 patients with urinary incontinence, 41 (56.2%) achieved urinary continence with a mean time of 15.4 months subsequent to the first year after radical prostatectomy (baseline). A younger age at surgery (P = 0.027) and one pad being required (vs≥2 pads) at baseline (P = 0.046) were identified as independent factors for achievement of urinary continence within a further 2 years. Only the number of pads was a significant factor for further recovery of urinary continence in the longer follow up (hazard ratio 0.36, P = 0.029).
Conclusion: Compared with factors related to the prostate or membranous urethra, patient age and severity of incontinence at 1 year after radical prostatectomy are more strongly related to the recovery of urinary continence later than 1 year after surgery. These findings might help to decide whether a definite treatment is required for persistent incontinence beyond 1 year after radical prostatectomy.